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HomeMy WebLinkAbout315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (5)Client#- 41916 RIGTHI ACORD. CERTIFICATE OF LIABILITY INSURANCE D/DD/YYYY) 1 /07/ /07/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: MIk1 Underwood Flood & Peterson Ins., Inc. FAX AI970 6-6820 ac°NNq mot, 970 5063224 50 No P. O. Box 578 ADDRESS: munderwood@floodpeterson.com Greeley, CO 80632 INSURER(S) AFFORDING COVERAGE NAIC III 970 356-0123 INSURER A: Philadelphia Insurance Companie INSURED INSURER B : Big Thompson Watershed Forum 800 S Taft Ave J �I C�� I INSURER C: Loveland, CO 80537 INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSIR LTR TYPE OF INSURANCE ADDL IN SUB POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDDIYYYY LBAfr3 GENERAL LIABILITY EACH OCCURRENCE E COMMERCIAL GENERAL LIABILITY EREMIJECEaoaunce $ CLAIMS-MADE OCCUR MED EXP (Any one person) E PERSONAL & ADV INJURY E GENERAL AGGREGATE E GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG E POLICY PR0. LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) E ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) E PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS W'B CLAIMS -MADE E _QED _RETENTICN_E__ WORKERS COMPENSATION _ _ MIT___ WC STATU- OTH- EEL AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a MIA - E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYEE E (Mandatory In NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMB S A Directors & PHSD908661 1/13/2014 01/13/201 $1,000,000 Occurrence Officers $1,000,000 Aggregate DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Attn: Lisa Voytko, Senior Process Engineer & Watershed Manager La.Lq,e,aa City of Fort Collins -Fort SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collins Water Treatment Facility ACCORDANCE WITH THE POLICY PROVISIONS. 4316 LaPorte Avenue Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE Xzlwa� ;w egAl:G� © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S8541281M854127 MILLI